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Wonkbook's Number of the Day: 10 percent. That's the chance that a person between age 24 and 34 could end up with a medical bill exceeding $13,000. Not exactly invincible, are they?

Wonkbook's Quotation of the Day: "If we become a society of a handful of biotech engineers working for companies that are going to move jobs overseas and the rest of us are fighting for jobs stuffing pickles into jars, that's not the kind of place you want to live," said Damon Silvers, the AFL-CIO's policy director, recalling a Durham, N.C., presidential summit on jobs.

HealthCare.gov is still 40 percent unfinished. "The chief digital architect for the federal health insurance marketplace said Tuesday that 30 percent to 40 percent of the project was still being built. The official, Henry Chao, made the assessment in testimony before a panel of the House Energy and Commerce Committee. Lawmakers expressed surprise that so much work remained to be done seven weeks after the federal website opened to the public. Mr. Chao, the deputy chief information officer at the Centers for Medicare and Medicaid Services, said the government was still working on “back office systems,” including those needed to pay insurance companies that are supposed to provide coverage to millions of people under President Obama’s health care law. “We have yet — we still have to build the financial management aspects of the system, which includes our accounting system and payment system and reconciliation system,” Mr. Chao said. These parts of the system, he said, are “still being developed and tested.”" Robert Pear in The New York Times.

Obama will meet with insurance commissioners today. "When they meet with Obama, members of the National Association of Insurance Commissioners (NAIC) will likely express their discontent with the administration over the executive action, which was proposed to quell the bipartisan outcry that the healthcare law doesn’t comply with the president’s promise that you can keep your plan if you like it." Jonathan Easley in The Hill.

Obama admin maps out detour around HealthCare.gov. "People interested in buying health insurance under Obamacare could soon skip the HealthCare.gov website and apply for coverage and financial assistance directly with private insurance companies and online brokers, the Obama administration said Tuesday, in its latest effort to work around the faulty website.... Activating the "direct enrollment" option would free health insurers and online brokers to accept applications from people who are eligible for subsidies, thus widening the potential universe of people who wouldn't need to use HealthCare.gov to get health insurance." Jeffrey Young in The Huffington Post.

The three things we learned from the latest Obamacare update. "Most of the high-priority problems with the "834 transmissions" have been fixed. Spokeswoman Julie Bataille kicked off the call by announcing that her agency has "completed fixes for two-thirds of the high priority bugs responsible with issues with 834 transactions." 834 transactions, as you might recall, are the forms that the exchange is supposed to send to insurance plans when someone signs up for a plan. But ever since HealthCare.gov launched, it has been spitting out inaccurate forms that make it difficult for insurers to know who has actually purchased their plan." Sarah Kliff in The Washington Post.

Doctors figure out how much Obamacare will cut their pay. "Insurance officials acknowledge they have reduced rates in some plans, saying they are under enormous pressure to keep premiums affordable. They say physicians will make up for the lower pay by seeing more patients, since the plans tend to have smaller networks of doctors...Physicians are uncomfortable discussing their rates because of antitrust laws, and insurers say the information is proprietary. But information cobbled together from interviews suggests that if the Medicare pays $90 for an office visit of a complex nature, and a commercial plan pays $100 or more, some exchange plans are offering $60 to $70. Doctors say the insurers have not always clearly spelled out the proposed rate reductions." Roni Caryn Rabin in Kaiser Health News.

Could it ever be worth just going without insurance? "[M]any consumers, particularly younger ones, may ultimately decide to consider their odds: A person 25 to 34 years old (insured or not) had a 5 percent chance of incurring medical bills of at least $27,000 in 2011, according to the Kaiser Family Foundation. The chance of ending up with a bill that exceeded $13,000 was 10 percent.... An estimated six million people are projected to go without that protection and pay the penalty in 2016, according to an analysis last year by the Congressional Budget Office and the Joint Committee on Taxation, though a majority of uninsured people will be exempt from the penalty because of hardship, low income or other reasons." Tara Siegel Bernard in The New York Times.

White House, Republican governors finally find Obamacare agreement. "The first signs of opposition to the White House proposal, meanwhile, have come from the law’s most ardent supporters, suggesting an early split between the state and federal officials who have so far worked on the Affordable Care Act hand-in-hand.... Regulators in five states -- Massachusetts, Minnesota, Rhode Island, Vermont and Washington -- so far have said they will not allow insurers to renew non-compliant plans through 2014. All five states have Democratic governors, are running their own marketplaces, and opted to expand Medicaid under the health law." Sarah Kliff in The Washington Post.

Obama had, in fact, seen the McKinsey report warning of a disastrous Obamacare launch. "White House press secretary Jay Carney said the president believed that the problems with the website were being addressed before its debut at the beginning of last month.... Carney said those officials were briefed on how the administration would attempt to address the issues raised by the report, and that Obama was told how the administration planned to tackle the concerns." Justin Sink in The Hill.

Obamacare enrollment … is kind of, sort of, working? "This is what many health policy experts predicted: The rate of enrollment would grow throughout November and mid-December up until Dec. 15, the last day to purchase coverage that begins on Jan. 1. There would likely be a bit of a lull until late December and early January, followed by more sign-ups in February and especially March, the last month of the open enrollment period. What they did not expect was a full month where it would be near impossible to purchase coverage through the exchange. And the looming question is whether enough people will sign up over the next four-and-a-half months to recover that lost ground." Sarah Kliff in The Washington Post.

Maryland struggling with technological problems with online insurance exchange. "In October, the exchange’s first full month of operation, 1,278 people signed up for the private plans, and 465 signed up in the first week of November. Those low numbers raise questions about whether Maryland will achieve its enrollment target of 150,000 by the end of March. The state has about 800,000 uninsured residents.... Maryland’s stumbles were unexpected, given that the state was one of the earliest and most enthusiastic supporters of the Affordable Care Act." Lena H. Sun in The Washington Post.

Taking the 'Obama' out of Obamacare. "With the president’s approval ratings at record lows, a broken website and Obama under fire for his pledge that people could keep their plans, the “Affordable Care Act” has returned. The president didn’t say “Obamacare” once during his nearly hourlong news conference last week, while he referred to the “Affordable Care Act” a dozen times. House Minority Leader Nancy Pelosi went so far as to correct David Gregory on “Meet the Press” Sunday on the proper terminology. And White House talking points distributed to Democrats and obtained by POLITICO repeatedly refer to the Affordable Care Act in suggested sound bites, not Obamacare." Reid J. Epstein in Politico.

Obamacare enrollment is easy for D.C. "Members of Congress like to boast that they will have the same health care enrollment experience as constituents struggling with the balky federal website, because the law they wrote forced lawmakers to get coverage from the new insurance exchanges. That is true. As long as their constituents have access to “in-person support sessions” like the ones being conducted at the Capitol and congressional office buildings by the local exchange and four major insurers. Or can log on to a special Blue Cross and Blue Shield website for members of Congress and use a special toll-free telephone number — a “dedicated congressional health insurance plan assistance line.” And then there is the fact that lawmakers have a larger menu of “gold plan” insurance choices than most of their constituents have back home." Robert Pear in The New York Times.

YGLESIAS: The broken system behind Healthcare.gov. "One place where people aren’t panicking is in the actual belly of the beast—the offices of CGI Federal, the U.S. division of the global IT services company whose slow and steady rise to power David Auerbach profiled earlier this month in Slate. CGI personnel continue to work on fixing the problem in advance of the president’s Nov. 30 quasi-deadline, but they are doing so in a not-especially-panicked manner. Officially the White House is trying to avoid spats with its partners, but government employees working on the site’s implementation tell me contractors have plenty of time to spend quibbling with the Department of Health and Human Services over which changes are really remedying defects and which are billable as new work." Matthew Yglesias in Slate.

@philipaklein: Obamacare/Katrina talk is comment on moments when ppl lose faith in prez. Not a literal comparison b/w a health care program & a hurricane.

CASSIDY: Americans like Obamacare where they can get it. "What these states have in common are state-run Web sites that are working pretty well; they are also all controlled by Democrats who are pushing the new reform. This progress points to something that has been absent in much of the reporting about the troubled rollout of healthcare.gov and the cancellation of individual policies: in places where Americans know about the comprehensive and heavily subsidized health coverage available under the Affordable Care Act and can easily access it, they are doing so in substantial numbers." John Cassidy in The New Yorker.

BARRO: 3 things we could do about rate shock. "Here's whose premiums would change if we got rid of the cap on age-based premium variation: Older adults making over 400% of FPL would pay more, and young adults would pay less. In other words, we'd be repealing an implicit transfer program created by Obamacare from moderate- and high-income young adults to moderate- and high-income older adults. What was the policy justification for that transfer?" Josh Barro in Business Insider.

@jimgeraghty: Option 1: The White House still has no idea of depth, breadth of problems with Obamacare. Option 2: They do, and they're lying.

JENKINS: How the GOP should fix Obamacare. "What can be done is Congress creating a new option in the form of a national health insurance charter under which insurers could design new low-cost policies free of mandated benefits imposed by ObamaCare and the 50 states that many of those losing their individual policies today surely would find attractive. What's the first thing the new nationally chartered insurers would do? Rush out cheap, high-deductible policies, allaying some of the resentment that the ObamaCare mandate provokes among the young, healthy and footloose affluent." Holman W. Jenkins Jr. in The Wall Street Journal.

@jimantle: Four score and seven years ago, our fathers tried to enroll in Obamacare.

SHIRKY: Tech planning and HealthCare.gov. "The management question, when trying anything new, is “When does reality trump planning?” For the officials overseeing Healthcare.gov, the preferred answer was “Never.” Every time there was a chance to create some sort of public experimentation, or even just some clarity about its methods and goals, the imperative was to deny the opposition anything to criticize. At the time, this probably seemed like a way of avoiding early failures. But the project’s managers weren’t avoiding those failures. They were saving them up. The actual site is worse — far worse —f or not having early and aggressive testing." Clay Shirky on his blog.

COHN: Where the Medicare Part D analogy for Obamacare falls short. "Obamacare’s architects guaranteed they’d make some people angry. And that is the biggest difference between what Bush did and what Obama did. Medicare Part D was all gain, no pain — the program gave millions of senior citizens access to drugs, without asking anybody to pay for it immediately. Instead, the program passes along the bill to future generations, for whom higher deficits mean fewer resources for public or private spending. The Affordable Care Act, by contrast, has gain and pain. Most of the people bearing the pain can arguably afford to bear it, and the consequences are frequently not what they imagine, but they won’t like it and they’re going to say so. Many already have." Jonathan Cohn in The New Republic.

BEUTLER: How Republicans could lose on Obamacare. "We now have pretty solid evidence that Obama administration officials are correct when they claim that the demand for insurance under the Affordable Care Act is substantial, but trapped behind the malfunctioning website. We also know that there will be a large, if somewhat balkanized constituency for Affordable Care Act insurance next year no matter what happens with Healthcare.gov. But this report is just devastating for — of all people — Sen. Mitch McConnell, R-Ky." Brian Beutler in Salon.

CHAIT: What poor people really need, Paul Ryan thinks, is no more food stamps. "The substance of Ryan’s anti-poverty agenda remains yet to be announced, but the general spirit of the endeavor can already be discerned from Ryan’s previous remarks, and those of the allies helping him formulate it. Ryan believes that the main impediment facing poor people is the existence of government programs that give them money and health care – a problem his budget rectifies by cutting subsidies to the poor." Jonathan Chait in New York Magazine.

SUNSTEIN: We owe the Beatles to luck. "You might think that the Beatles, probably the most successful popular musicians in the last 50 years, were bound to succeed. But an astonishing new book, "Tune In," by Mark Lewisohn, suggests otherwise. Without explicitly saying so, Lewisohn’s narrative raises the possibility that without breaks, coincidences and a lot of luck, none of us would have ever heard of the Beatles." Cass R. Sunstein in Bloomberg.

PORTER: Climate change's one answer. "How will the world replace fossil fuels? Can it be done fast enough, cheaply enough and on a sufficient scale without nuclear energy? For all the optimism about the prospects of wind, sun and tides to power our future, the evidence suggests the answer is no.... The good news is that the sun and the wind are not the world’s only alternative to fossil fuels. There are risks associated with nuclear power, but it looks a lot better than the energy we’ve got." Eduardo Porter in The New York Times.

MATTHEW C. KLEIN: Is the only choice bubbles or recession? "The simplest explanation is that there haven't been enough productive investment opportunities relative to the world's total desire to save. According to this view, bubbles can transform wealth that would otherwise be stashed in government bonds and other safe assets into income for those who work in the expanding parts of the economy.... It seems more likely that the real problem is the dramatic concentration of wealth and incomes during the past 30 years. Those who have much more than they can ever hope to spend don't increase their consumption by much when their incomes increase. Instead, they tend to save the extra dollars. Many others tried to compensate for their stagnant incomes by borrowing more and more." Matthew C. Klein in Bloomberg.

KERREY AND LEEDS: What's wrong with Obama's ed-reform plan. "The rules are poorly designed. To give just one example, the proposed regulation will cap graduates' annual debt payments to 8% of their third- and fourth-year postgraduation earnings. If they are any greater, the school program from which the student graduated will lose its ability to accept federal aid — even if each and every graduate pays back his or her loans fully, and on time.... Another problem: Institutions are likely to admit fewer poor students who have to finance their education. The more a student borrows, the less well the program is assessed by the feds." Bob Kerrey and Jeffrey T. Leeds in The Wall Street Journal.

Here Reid comes on the filibuster. "Senator Harry Reid, the majority leader, is prepared to move forward with a vote that could severely limit the minority party’s ability to filibuster presidential nominees, possibly as early as this week, Democrats said Tuesday... .Exasperated with the refusal of Senate Republicans to confirm many of President Obama’s nominees, Mr. Reid has been speaking individually with members of his caucus to gauge whether there is enough support to change filibuster rules." Jeremy W. Peters in The New York Times.

What happened was that some key Democratic senators changed their minds. ""I am very open to changing the rules for nominees," Sen. Barbara Boxer (D-Calif.) told The Huffington Post. "I was not before, because I felt we could work with them. But it's gotten to an extreme situation where really qualified people can't get an up-or-down vote." "I do now," Sen. Dianne Feinstein (D-Calif.) told reporters when asked if she supports filibuster reform. She said she changed her mind on the issue after watching as a bipartisan deal to let President Barack Obama's nominees get votes, struck over the summer, went nowhere." Jennifer Bendery in The Huffington Post.

Why this is no longer a dance. "“Reid has become personally invested in the idea that Dems have no choice other than to change the rules if the Senate is going to remain a viable and functioning institution,” the aide says...Asked if Reid would drop the threat to go nuclear if Republicans green-lighted one or two of Obama’s judicial nominations, the aide said: “I don’t think that’s going to fly.”" Greg Sargent in The Washington Post.

Bernanke's message: The Fed is back in easing mode. "On Tuesday, Bernanke hinted that short-term rates would likely remain low even after unemployment reaches the Fed’s thresholds. He specified for the first time other measures of the labor market’s health that officials may consider, such as job growth, labor force participation and the rates of hiring and separation. “So long as inflation remains well behaved, the [Fed] can be patient in seeking assurance that the labor market is sufficiently strong before considering any increase,” he said." Ylan Q. Mui in The Washington Post.

Evans: QE3 may total $1.5 trillion. "“Given the current conditions, I won’t be surprised if it is $1.5 trillion,” Evans, a consistent supporter of record stimulus, said in a speech today in Chicago. “It could be a little more than that.”...“Now it looks like we are going on longer at the full $85 billion pace,” Evans said to reporters. “I had said it was likely to be about $1.25 trillion several months ago.” The Fed should be careful not to prematurely reduce bond purchases because it’s not certain labor market improvements are sustainable, Evans said. “I am not in a hurry myself to reduce the flow of purchases,” he said. “I’d rather wait just a little bit longer and have more confidence.”" Steve Matthews in Bloomberg.

Shiller vs. Fama vs. the skeptics. "Robert Shiller and Eugene Fama, sharing a stage for the first time since it was announced last month that they would share the 2013 Nobel Memorial Prize in Economic Science, sparred with languorous familiarity Tuesday about the efficiency of financial markets. The electricity, somewhat surprisingly, came from some of the chemists and biologists who joined the two men on a stage at the House of Sweden in Washington for a discussion featuring all nine of the nation’s 2013 crop of Nobel laureates. The sparks began to fly after Professor Fama responded to a question about the recent rise in stock prices by declaring that markets are efficient -- “of course” -- and that he could not predict what would happen next because that is impossible to predict." Binyamin Appelbaum in The New York Times.

OECD cuts global growth forecasts. "The OECD on Tuesday knocked almost half a percentage point off its forecasts for global growth this year and next, blaming a slowdown in emerging markets, brinkmanship over the US debt ceiling and concerns over the Federal Reserve’s tapering for the downgrade. The Paris-based organisation promoting the world’s largest advanced economies said the global economy would expand 2.7 per cent this year and 3.6 per cent in 2014, compared with estimates of 3.1 per cent and 4 per cent, made in May...The US economy would grow 2.9 per cent next year, it said." Claire Jones in The Financial Times.

Organized labor is in trouble. This guy is supposed to think of a way out. "Damon Silvers still remembers the pickles. In 2011, at a roundtable discussion in Durham, N.C., the President's Council on Jobs and Competitiveness showcased biotech firms that weren't planning to hire anybody, remnants of the textile industry, and an artisan pickle maker. Silvers, the policy director of the AFL-CIO, concedes that the jobs council was celebrating some wonderful entrepreneurial people. But really, he says, it was evidence of a collapsing industrial economy and a president who seems to have given up on pushing a comprehensive progressive agenda." Lydia DePillis in The Washington Post.

How the safety net held up in the recession. "Robert A. Moffitt, an economist at Johns Hopkins University, says in a new paper that the country’s social safety net did a good job during the recession, expanding by half a trillion dollars. Mr. Moffitt looked at means-tested programs including food stamps, Medicaid, unemployment benefits and the earned income tax credit to determine the increase between 2007 and 2010. He found that spending increased by $500 million and the total caseload rose to 310 million from 276 million." Shaila Dewan in The New York Times.

New hurdles for the Volcker rule. "Two top regulators are raising new — and late — objections to the "Volcker rule," arguing it is too soft on banks and threatening to further delay its implementation beyond the year-end deadline set by the Obama administration.... At the SEC, a newly installed Democratic commissioner, Kara Stein, has raised a number of concerns about the current version of the rule, which has been under discussion for three years. Ms. Stein, a former congressional staffer who helped draft the Dodd-Frank law, believes the rule allows banks to sidestep its purpose, people familiar with her views said." Scott Patterson and Andrew Ackerman in The Wall Street Journal.

JPMorgan’s settlement: A win for communities hit hard by housing crisis. "The Justice Department scored a colossal victory Tuesday in its record $13 billion settlement with JPMorgan Chase, and some communities devastated by the housing crisis could also walk away with a big win. The landmark agreement, which resolves a myriad of government probes into the bank’s sale of defective mortgage securities, carves out more than $4 billion to help struggling homeowners and neighborhoods riddled with abandoned or foreclosed houses." Danielle Douglas in The Washington Post.

Bitcoin needs a central banker. "[T]his runup is also an example of one of the most profound challenges that Bitcoin faces in becoming widely used in mainstream commerce. For a currency, wild swings in value are a bug, not a feature, even (perhaps especially) when that swing drives the value upward...Fortunately, there is a possible solution for Bitcoin's volatility problem: There needs to be some kind of central institution. A bank of sorts. One with the bottomless ability to either pump extra Bitcoin into the market or suck it out, depending on what's needed to maintain stable prices." Neil Irwin in The Washington Post.

The Dow is hitting a record high. No, for real this time. "The Dow is approaching its actual inflation-adjusted closing record. I asked William J. Hausman, a professor of economics at the College of William and Mary, to crunch the numbers. Hausman says he was glad to do it; the media reporting index figures without adjusting for inflation is one of his pet peeves. Here’s what he came up with: Adjusting the figures using the consumer price index for all urban consumers (or the CPI-U) from September, the all-time closing high for the Dow Jones Industrial Average was set Jan.14, 2000, at 16,261.40. On Tuesday morning, the Dow crossed 16,000 yet again, meaning we’re getting close." Jia Lynn Yang in The Washington Post.

Energy Dept. must stop collecting nuclear-waste fees. "A federal appeals court ruled Tuesday that the Energy Department must stop collecting fees of about $750 million a year that are paid by consumers and intended to fund a program for the disposal of nuclear waste. The reason, the court said, is that there is no such program...The energy secretary is supposed to set the level of the fee based on the costs of the program, and the department had argued that for the purposes of calculation, it should continue using what the cost would have been at Yucca. But the Energy Department has dismantled the office that was pursuing the Yucca project." Matthew L. Wald in The New York Times.

Of all the things to cut, it seems like nuclear-power regulation might be one of the dumbest. "Budget cuts and financial challenges will likely cause the Nuclear Regulatory Commission to cut back and delay some of its services, Chairwoman Allison Macfarlane said on Tuesday. In remarks to a nuclear power conference in Atlanta, Ga., Macfarlane said that the 16-day government shutdown in October was only the “most recent and most problematic” outside finance challenge. Across-the-board cuts from sequestration and Congress’s reliance on a series of short-term budget measures have also contributed to uncertainty at the agency, she said, according to prepared remarks." Julian Hattem in The Hill.

Why you should care about cleaner wood-burning stoves. "It is not rocket science, but the 12 teams that are competing to solve the problem are finding ways to get twice as much heat out of a log of firewood. The effort preserves woodlands, reduces the labor and expense for the mostly low-income people who use wood, and cleans the air. The stoves on display here, in a tent with a dozen chimneys incongruously poking through the roof, use combinations of computer controls, catalytic converters and sophisticated gas-flow modeling....[W]ood was the primary source of heat for about 2.3 million American households, largely in rural areas." Matthew L. Wald in The New York Times.

Harvard president sounds alarm over sequester. "Harvard University President Drew Faust warned Tuesday of continuing to cut scientific research budgets, saying even the nation’s wealthiest university is losing faculty to countries where governments are spending more on research. Harvard gets 16 percent of its budget — $600 million per year — from federal research spending, much of that for medical research. The university is fund-raising and seeking nonprofits and corporations to help support research, Faust said during a meeting with POLITICO editors and reporters, in part because the basic partnership between universities and the government is at risk." Libby A. Nelson in Politico.

Lew wants debt-ceiling reform. "U.S. Treasury Secretary Jacob Lew on Tuesday said policy makers should consider a "reform" of the government's longstanding borrowing limit, saying it could help to prevent future fiscal clashes that he said harm economic growth. "The full faith and credit of the United States, whether it's bonds or contracts or benefits, has to be honored," Mr. Lew said at the Wall Street Journal's CEO Council meeting. "The whole idea of debt limit reform is probably something we should think about."" Damian Paletta in The Wall Street Journal.

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